Provider Demographics
NPI:1134385586
Name:FITZPATRICK, MELISSA (MSW)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:765 S MAIN ST STE 104
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-5141
Mailing Address - Country:US
Mailing Address - Phone:603-696-6314
Mailing Address - Fax:603-825-7712
Practice Address - Street 1:765 S MAIN ST STE 104
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-5141
Practice Address - Country:US
Practice Address - Phone:603-696-6314
Practice Address - Fax:603-825-7712
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-05
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH12151897OtherCAQH